Provider Demographics
NPI:1598756843
Name:KANDLER, CHARLES JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:JOSEPH
Last Name:KANDLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:200 N VILLAGE AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-2341
Mailing Address - Country:US
Mailing Address - Phone:516-766-2929
Mailing Address - Fax:516-766-7728
Practice Address - Street 1:200 N VILLAGE AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-2341
Practice Address - Country:US
Practice Address - Phone:516-766-2929
Practice Address - Fax:516-766-7728
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY136196208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY340004031OtherRAIL ROAD MEDICARE
NYCK097A8910OtherBLUE CROSS BLUE SHIELD
096588-A32OtherHEALTH FIRST
21138OtherVYTRA
113480OtherAETNA
136196OtherHIP
2C7197OtherCARE CORE
AB00723OtherMNDY
AS1074OtherOXFORD
2C7197OtherHEALTH NET
5252217001OtherCIGNA
1000374OtherGHI
000000068633OtherGHI HMO
NY97A8917981Medicare PIN
000000068633OtherGHI HMO
5252217001OtherCIGNA